Market share of health insurance groups in the Netherlands 2006-2021

In 2021, the four biggest health insurance groups in the Netherlands saw their market share decrease in favor of their smaller competitors. Insurance groups are known as "concerns" in the Netherlands. Note that this wording of concern matters a lot for Dutch healthcare. In the Netherlands, there are 11 large health care insurance concerns, each with multiple companies. The concern Achmea, for example, owns the following companies (commonly referred to as zorgverzekeraars: Agis Zorgverzekeringen, Avero Achmea Zorgverzekering, FBTO, Groene Land Interpolis Zorgverzekeringen, OZF Zorgverzekeringen and Zilveren Kruis Zorgverzekeringen. In addition, some of these companies also own multiple health insurance brands or labels. To stick to the example of Achmea, this concern owned six ompanies but also the labels of ZieZo and Pro Life, which belong to Zilveren Kruis. In total, the 11 concerns were responsible for a total of 39 companies or health insurance brands.

In the Netherlands, every resident or employee is obliged to take a basic health insurance to cover medical costs from, for example, visits to a general practitioner or the hospital. The Dutch government decides on the cover provided by this package and health insurance companies are obliged to accept everyone who meets the requirements, regardless of age or state of health. As not all care is covered by this standard insurance, one can opt to take out additional health insurance cover for, for example, physiotherapy and dental care. In 2018, the average annual premium for additional health insurance reached a value of approximately 316 euros per person.

It is allowed in the Netherlands to cancel one's basic health insurance and change insurance companies every year until the 31st of December. When individuals end their contract before the end of December, their contract will end per January 1st. They can then choose a new health insurance company before February 1st. In 2020, the share of individuals who switched health insurance companies reached a value of approximately 6.5 percent.